breastfeeding & anesthesia

Your question:

Can I breastfeed after my gallbladder surgery -- and will the anesthesia affect my baby?

The expert answers:

Breastfeeding is a good thing -- so much so, the American Academy of Pediatrics recommends an infant be given nothing else but breast milk for their entire first year of life!

A breastfeeding mother may undergo surgery because of ailments that arose during pregnancy but were non-emergent. Often the surgeon will postpone surgery until after delivery -- for example excision of a lump or bump. Sometimes pregnancy can aggravate an underlying problem like gallbladder disease (cholelithiasis, cholecystitis) and the mom will need a cholecystectomy (surgical removal of gallbladder).

Medications given for surgical anesthesia circulate in the bloodstream and are eliminated via the lungs (breathed out), kidneys or metabolized by the liver. The majority of medications and inhaled anesthetic agents are excreted into the milk, but in very minute quantities. Not only does the medication get diluted out in the mother's bloodstream, the amounts that are excreted into the milk are very small.

Assuming a patient is able to do so, most physicians do not mind if a mother breastfeeds immediately after a surgical procedure. Remember, the mother/patient must be awake and alert enough to hold the baby.

The surgical procedure determines which type of anesthesia may be used. General inhalational, regional (epidural, spinal, local anesthetics) or intravenous medications (twilight) or a combination may be given. Will the baby absorb these drugs via the breastmilk? Yes, but in relatively insignificant amounts. The amounts absorbed by the baby during breastfeeding are small compared to the blood levels reached when a baby receives anesthesia for a surgical procedure on itself.

The circumstances surrounding each surgery and anesthetic can vary, so plan to ask your physician about breastfeeding during your pre-op visit.